SUMMARY

Maternal mortality is a significant contributor to the premature death of women in Ethiopia. As of 2020, Ethiopia had the fourth highest number of maternal deaths among all countries worldwide. While some of the conditions precipitating these deaths are unavoidable or already being addressed with novel interventions, others, like preeclampsia (PE), still require solutions for improved prevention. PE is a gestational vascular disorder and the second leading cause of maternal death globally. Low-dose (and low-cost) aspirin administered early in pregnancy can reduce the risk of developing PE, but current methods for PE risk screening require high-resource technology that is widely inaccessible in Ethiopia and other low- to middle-income countries (LMICs). Therefore, there is a need to develop an alternative and low-cost screening method to assess for the risk of developing PE in LMICs like Ethiopia.

To address this challenge, we planned and executed a preeclampsia research study in Ethiopia, gathered a wide array of hemodynamic and biochemical data, and are now developing an alternative method to screen for PE risk. In this work, we demonstrate that there are statistically significant differences between femoral and brachial pressure waveforms in participants with varying uterine artery perfusions (which is typically measured directly by high-cost ultrasound in developed countries to predict for the risk of developing PE). We then perform statistical shape analysis using principal component analysis (PCA) to characterize these waveform shapes differences and demonstrate even greater statistically significant differences between perfusion groups. Upon further development, this technique will provide a low-cost and low-expertise alternative to predict the risk of developing PE and guide antenatal care in Ethiopia and other LMICs.